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2017 - Demo House and Abandon Septic &Well
Field Inspection Notice Town of Montville Building Department September 13, 2017 2016 Ct Building Code Address: 40 Broadview Avenue Job Description: Demo Single Family Residence—Abandon Septic &Well Permit Number(s) D2017-0010 Permit Date: August 28,2017 Not Approved Approval INSPECTION Date: Deficiencies Special Date Conditions • • Site is clean and 9/13/17 DJ Demo restored • Final inspection and • 9113117 DJ certificate of approval • Page 1 of 1 Rev.Date: 1/18/06 TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 DEMOLITION PERMIT Permit Number: D2017-0010 Date: 28-Aug-17 Map/Lot: 107/009-000 Owner ID: 381000 Project Location: 40 BROADVIEW AVENUE Unit: Job Description: Demo Single Family Residence-Abandon Septic&Well Owner Nam MTIC Acquisitions LLC Tenant Name N/A Careof: Lou Ziegler 13 Crow Hill Road Uncasville CT 06382- Telephone: (860)862-6100 Applicant Name David Rubino Telephone: (860)608-7680 DBA: Rubino Construction Lic/Reg Type B Lic/Reg N 1997 501 Taylor Hill Road Exp Date: 31-Mar-18 Griswold CT 06351- Construction Value Permit Fees Construction Information Building Value: $60,840.00 Building Fee: $610.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2016 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $60,840.00 Penalty Fee: $0.00 Permit Code: M1 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 State Ed Fee: $0.00 Total Fee Paid: $610.00 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL, ELECTRICAL PERMIT INSPECTIONS ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete ❑ Pool Bonding ❑ Anchor Bolts-with sill plate and prior to floor frami ❑ Electrical Service CRS No: Q ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation • Certificat- -f Approval Ce j' ate of Occupancy Building Official's Approval: Building Department 310 Norwich-New London Tpke. Tel. 860-848-6782 Uncasville, CT 06382 Fax. 860-848-7231 DEMOLITION APPLICATION FORM Permit No.:(: )I7 —0016 Property Address: , 4 0 GQOAb VifAiv A'2 (Number) (Street) �` (Unit) Job Description: 1 1\)) 14,,k:��F iA,�L !U��1rj - Dfie Amb vut;".1% Owner: 111 C H (Z.1.›4 N TR-1 t E Address: 5 Cao\A) i--% i %t City: U N Ci v i t kE_ State: C I - Zip Code: C' 5 f 1` Telephone( L( t`.1(. - (i(CC) Applicant: I-- kl t 7 FAV a1,N V DBA: V 31 NIC G--' -C-t-&(T"1 UN.) Address: -S–(--- O `SAM LV 11 N i 0 (�.D. City: Z \;VC�t..v� State: CST ZipCode: L�[ }� ( _'>.5 1 Telephone( fr:()) l{�;; - 7�Fr) Contractors-Complete the Following: License Type: CLACS 3 License No.: I Clr17 Expiration Date: - 31-1 6 We the undersigned agree to comply with all the restrictions and regulations set forth in sections 29-401 through 29-415 of the Connecticut General Statutes entitled"State Demolition Code"and hereby certify that the proposed work will conform to the State Demolition Code, State Building Code and all other codes as adgpTl�d by the State of Connecticut and the Town of•;,ontville. Owner Signature:' \J p !_ , Date: 9)• /L Contractor Signature ► Date: Cl .I¢-17 Zoning and Wetlands Approval ��� /� / k, � Q Uncas Health District approval4111P1 `..�---.. Note: If asbestos abatement requires removal of building components i.e. doors and/or windows the abatement must be completed and the clearance letter submitted to the district prior to any further demolition of the structure. Tax Assessor–Assessed Value of Structure to be Demolished '' Demolition Fee: 4a , -y° ,vv ‘/c1 o0 See Reverse Side for Items Required for Submission of Application DemoCitionPermit Application fomt Revised 02/01117 Town of Montville Building Department File Receipt Date: 72 Aua 17 ReceiptNo: 12584 Received From: David Rubino Job Address: 40 Broadview Ave Town Fees Collected State of Connecticut Fees Collected Bldg Cash: 10.00 State Cash: 10.00 Bldg Check: 1610,00 State Check: $0.00 Bldg Credit: 10.00 State Credit: $0,00 Fire Cash: 10.00 Fire Check: 10.00 Fire Credit: $0 00 Construction Value: 10 00 ..'Rion Valu:: $61.000.00 CheckNo: 3756 Received By: Vernon D Vesey II Rubino Construction 501 Taylor Hill Rd, Griswold, CT 06351 860-608-7680 860-961-8736 daverubino@sbcglobal.net In accordance with Connecticut General Statutes Sec. 29-406, we, Rubino Construction, hereby agree to save harmless the Town of Montville and it's agents from any claims arising out of negligence of the applicant or his/her agents or employees in the course of the demolition operations assiociated ' 8 Broadvi' Ave, Uncas 'lle, CT 06382 David A Rubino Rubino Construction 7.'fir 0 Abutters List Report Montville, CT G 0August 14,2017 Subject Property: Parcel Number: 107-006-000 Mailing Address: MTIC ACQUISITIONS LLC CAMA Number: 107-006-000 13 CROW HILL RD Property Address: 28 BROADVIEW AVE UNCASVILLE, CT 06382 Abutters: Parcel Number: 056-003-000 Mailing Address: USA IN TRUST FOR THE MOHEGAN CAMA Number: 056-003-000 TRIBE OF INDIANS OF CT Property Address: 67 SANDY DESERT RD 13 CROW HILL RD UNCASVILLE, CT 06382 Parcel Number: 107-005-000 Mailing Address: MTIC ACQUISITIONS LLC CAMA Number: 107-005-000 13 CROW HILL RD Property Address: 24 BROADVIEW AVE UNCASVILLE, CT 06382-1118 Parcel Number: 107-007-000 Mailing Address: AHMAD NAJEH S &VICKI R CAMA Number: 107-007-000 7720 CITRUS HILL LN Property Address: 32 BROADVIEW AVE NAPLES, FL 34109 �Tlcrloioll,-eS' www.cai-tech.com Data shown on this report is provided for planning and informational purposes only.The municipality and CAI Technologies 8/14/2017 are not responsible for any use for other purposes or misuse or misrepresentation of this report. Page 1 of 1 Abutters List Report-Montville, CT David Fowler From: ctnewservice@eversource.com Sent: Wednesday, September 21, 2016 10:31 PM To: David Fowler Subject: Removal of Service Completed (2793926) WARNING: External email. Please verify sender before opening attachments or clicking on links. • WARNING: External email. Please verify sender before opening attachments or clicking on links. From: CLP New Service Clearing Desk/NUS@NU Date: 19-SEP-16 To: Fowler,David Subject: Removal of Service Completed (2793926) Dear Customer, Your CL&P Demolition/Construction Service Removal Request: 2793926 for Job Location: 28 BROADVIEW AVE, MONTVILLE, CT has been completed. Service Removal Date: 19-SEP-16 This letter is to confirm the removal of the existing Connecticut Light& Power(CL&P) electric service and meter(s) at the above address for the purpose of demolition/construction of the building. If you have any questions, please contact the CL&P Clearing Desk: Phone: 1-888-544-4826 Fax : 1-877-285-4448 This electronic message contains information from Eversource Energy or its affiliates that may be confidential, proprietary or otherwise protected from disclosure. The information is intended to be used solely by the recipient(s) named. Any views or opinions expressed in this message are not necessarily those of Eversource Energy or its affiliates. Any disclosure, copying or,distribution of this message or the taking of any action based on its contents,other than by 1 TOWN OF MONTVILLE WATER POLLUTION CONTROL AUTHORITY 310 NORWICH-NEW LONDON TPKE UNCASVILLE, CT 06382 Phone-860-848-6776 Fax-860-848-4354 August 15, 2017 Re: 28 & 40 Broadview Ave To whom it may concern; The above property, 28 & 40 Broadview Ave is not connected to city sewer or connected to city water. Regards, Maureen Benway Town of Montville WPCA Mystic Air Quality Consultants, Inc. 1204 North Road, Groton, Connecticut 06340 www.mysticair com magc2(aaol.com 800 247-7746 n 1987 ,S`, OA, I'SULT P►� August 18,2017 Mr.Jim Butler Asbestos Removal&Containment 88 Leitao Drive Oakdale,CT 06370 Re: Post Abatement Inspection(8/18/17) Pre-Demolition Review 40 Broadview Ave Uncasville,CT Location: Rear Chimney Flashing Dear Mr.Butler: On August 18,2017 our asbestos abatement project monitor,David Goldstein(monitor license#000022)completed visual inspections at the above location for fulfillment of criteria for inspection prior to demolition. This site review was for the purpose of determining whether the asbestos-containing materials sited in the asbestos inspection were completely removed in order to allow for demolition to go forward, with regard to asbestos issues. ACM Materials At this time,all of the stipulated asbestos-containing materials are completely removed from the structure and property. There is no visible asbestos related dust or debris remaining from these materials in the building,as required by US EPA NESHAPS and the State of Connecticut regulations to allow demolition to proceed. As allowed for by state standards for exterior asbestos abatement,there was no final air test performed at this site. Thank you for selecting Mystic Air Quality for these services. Sincerely, istopher J.Eident CIH,CSP,RS CEO Mystic Air Quality is an AIHA-LAP, LLC Accredited Lab FAX: 860 449 8860 AIR �: -, Mystic Air Quality Consultants, Inc. 1204 North Road, Groton, Connecticut 06340 C� t987�` �c`"''�-rre}sticaircorrr rnagc2�aaol.corrr 800147-7746 MSCTLTP Report of Inspection of Asbestos Removal, FINAL Renovation, and/or Demolition Project I`TERIII Date: __,F/X/7 Site Location: !2"p �j,.•a€L e — Building Identification: ir�4J // t. 7 Containment Location: 4,, 14 FINAL INSPECTION PASSED ( J INSPECTION INDICATES MORE WORK TO BE DONE CHECKLIST: Residual Dust On: YES N YES L O a. Floor f b. Horizontal Surfaces _ g. Ducts c. Pipes h. Register _ d. Ventilation Equipment i. Lights e. Vertical Surfaces FIELD NOTES: .er+a - FINAL AIR SAMPLE RESULTS: ( ) T i I—to be Analyzed ( ( M—Analyzed on Site Sample# Sample »_ Sample# _ Sample Sample# — — — INSPECTOR -c, ENCLOSURE I PAGE I OF Mystic Air Oualih is an AIf-I-1-LAP. LLC Accredited Lab FAX:: 860 449 8860 PI ' zz mmM I a " a..- M Z m °' r" 00 rs, in ik \ \ . to C r 7.../.. !9s J� \ rrlri �, s ,,k P. Q 1 i % sj 9. ' It 14 v k INftN b - � 2. r) \ 0 ta S 0 et ell NJ ft ti i F\N 4%. . hill.4 Fi Z. a o COI .121 (S`. r-C / '.1 w Co) ,14.4 a zv ,�I 4D .0 , t..1 co O S !ip. cpp oao• 9 a "rf 0 z C. °4 i (4 0 \ ENCLOSURE ) PAGE .20F 4 r Y,=s --j LICENz E NO:1997 CLASS:H t t -This License is being issued pursuant to Connecticut General Statute 29-402 to: Rubino Construction 501 Taylor Hill Rd Griswold CT 06351 I Designated Technical Expert: David Rubino Class B is limited to the demolition of i buildings not to exceed 2 1/2 stories or , 35 feet in height Issued by: C,,.., ice. _,5_ r. Commissioner P. Date Issued: 2017/04/01 Expires: 2018/03/31 . DEMOLITION CONTRACTOR LICENSE A From: Daverubino daverubino�a-sbcglobal.net � a3: Subject: Fwd:Frontier Facility Removal Date: August 22,2017 at 11:03 AM µ; To: Lori Dziedzic loriadzi@gmail corn Sent from my iPad Begin forwarded message: From: David Fowler <dfowler@moheganmail.com> Date: August 22, 2017 at 10:39:52 AM EDT To: "daverubino(asbcglobal.net" <daverubinoCasbcglobal.net> Subject: FW: Frontier Facility Removal FYI From: Paula Camillucci Sent: Tuesday, August 22, 2017 10:39 AM To: David Fowler Subject: FW: Frontier Facility Removal Here you go, From: Elliott, William [mailto:william.o.elliott(aftr.com] Sent: Tuesday, August 22, 2017 10:37 AM To: Paula Camillucci Subject: Frontier Facility Removal WARNING: External email. Please verify sender before opening attachments or clicking on links. Aerial phone lines are disconnected at 28 & 40 Broadview ave Buried phone lines are disconnected at 45 Sunny Hill dr, Units 5, 6, 7, & 8 Bill Frontier Communications This communication is confidential. Frontier only sends and receives email on the basis of the terms set out at http://www.frontier.com/email disclaimer. From: Daverubino daverubino 4sbcglobai net g Subject: Fwd:Demo Letter Date: August 19,2017 at 9:43 PM .-'. To: Lori Dziedzic ionadzi@gmail.com Sent from my iPad Begin forwarded message: From: David Fowler <dfowler@moheganmail.com> Date: August 18, 2017 at 10:58:04 AM EDT To: "daverubino@sbcglobal.net" <daverubino@sbcglobal.net> Subject: FW: Demo Letter FYI From: Paula Camillucci Sent: Friday, August 18, 2017 10:57 AM To: David Fowler Subject: FW: Demo Letter From: Giannattasio, Mark [mailto:mgiannattasio{a�atlanticbb.com] Sent: Friday, August 18, 2017 10:57 AM To: Paula Camillucci Subject: Demo Letter WARNING: External email. Please verify sender before opening attachments or clicking on links. Friday, August 18, 2017 Paula Camillucci Re: 28 Broadview Ave. 40 Broadview Ave Uncasville,CT To Whom It May Concern: This letter confirms that there are no cable drops of Atlantic Broadband attached to the property referenced above as of the date of this letter. Sincerely, Mark Giannattasio ACC0120 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 08/18/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Byrnes Agency, Inc. - Norwich NAME: Aimee Santiago 6 Consumers Avenue A/�NNo,Ext)_ (860) 886-5498_ A1c,No):(860) 859-5075 E-MAIL Norwich CT 06360-7521 ADDRESS: asantiago@byrnesagency.com INSURER(S)AFFORDING COVERAGE NAIC# -- _ INSURER A:NGM Insurance Company 14788 INSURED (860) 376-0380 INSURER B:Main Street America Assurance 29939 David Rubino Dba David Rubino Construction - - --- INSURERC:United Ohio Insurance Co 13072 -- — - ------ --- 501 Taylor Hill Rd ISURERD_Hartford Underwriters 3.0104_ Griswold CT 06351 INSURER E: T INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 18294 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR! - 1 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IN SD,WVD POLICY NUMBER i(MM1DD/YYYY) (MMIDD/YYYY)I LIMITS B x 'COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 RENTED CLAIMS-MADE 1 X OCCUR MPS0919R 10/23/2016:10/23/2017 PREMSESO(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY I$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY i JECT LOC PRODUCTS-COMP/OP AGO i 5 4,000,000 1 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT C (Ea accident) J__ _,(200, 000 ANY AUTO CPP0022010 104/12/2017 04/12/2018 BODILY INJURY(Per person) OWNED SCHEDULED ' AUTOS ONLY % AUTOS 1 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE 1$ .1_1 AUTOS ONLY AUTOS ONLY (Per accident) A I X1UMBRELLA LIAB X OCCUR I CUS0919R 10/23/2016 10/23/2017 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB lI CLAIMS-MADE 1 ! AGGREGATE ,$ 1,000,000 I DED % RETENTION$ 10,000 - A regate $ 1,000,000 WORKERS COMPENSATION _ 0 AND EMPLOYERS'LIABILITY YIN 6S6OUB-2E86560-7-17 '.,04/15/2017104/15/2018 % STATUTE i 'PRH ANYPROPRIETOR/PARTNER/EXECUTIVE ! ! EL EACH ACCIDENT 1$ 100,000 OFFICER/MEMBER EXCLUDED? Y IN/A (Mandatory in NH) 1 E.L.DISEASE-EA EMPLOYEE:$ 100,000 It yes,describe under - DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT I$ 500,000 I i5 $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Montville ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 310 Norwich New London Tpke. AUTHORIZED REPRESENTATIVE Uncasville CT 06382 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1